Australia Needs Physician Assistants. So Why Aren’t We Getting Them?

It would be good to hear your responses to the pro-PA arguments that have been made. Meanwhile, Professor Peter Brooks, director of the Australian Health Workforce Institute, explains below why he believes that Australia needs PAs. (Incidentally, he is also due to speak at at a University of Sydney seminar on May 3 titled Are we training too many doctors?.) Professional self-interest is blocking introducton of physician assistants Peter Brooks writes: Well done Croakey for running these stories on Physician Assistants (PAs). The opposition to the introduction of these health workers mirrors very much what happened in the US some 40 years ago. Strident cries from the American Medical Association that their introduction would end life as we know it. But interestingly it didnt! Why the nurses are so actively against it is interesting but one would have to ask all opposing groups are they interested in opposing for oppositions sake, are they interested in providing health services to patients who currently find it difficult to access them because the workforce is not there, or are they interested in preserving the status quo with siloed health professional practice? The health service and its constituent parts is a very complex organism but every part of it should work together to improve patient care and not work only in the interests of the health professional or have I got that wrong ? The health and social welfare workforce is currently the largest in Australia 1.4 million and like the rest of the population, it is ageing. We will need to recruit about half a million new workers at least to this sector over the next decade a significant challenge that policy makers and politicians do not seem to be fully accepting at present. Where are these new workers to come from? Current recruitment will not achieve these targets so perhaps some innovation is required. Trials of new models of care have been carried out by Queensland Health and the South Australian Health Commission in respect to PAs. These trials, albeit small, did suggest that these new health professionals would be useful across a variety of health care situations.

Despite a decade of discussion and two successful pilot programs, says the report, there remains a high level of misunderstanding about the clinical role and professional attributes of PAs and how they might complement and add value to existing team structures. On a related note, the report says: Those who openly declared their opposition to introducing PAs in Australia were likely to advocate for the interests of existing professions, either nursing or medicine. (Croakey wonders if this gives any hint of the reason for the NSW resistance: are the medical and nursing lobbies more influential in NSW?) The report also notes the potential of PAs to reduce health care costs by providing a new workforce group to provide safe and effective services at lower cost. The report, considered by the Australian Health Ministers Advisory Council (AHMAC) in February, has been keenly awaited by PAs and their supporters, including one of the first PAs to graduate in Australia,Ben Stock, who writes below that action is now needed. *** Report represents overwhelming support for PAs Ben Stock writes: In 2011, Health Workforce Australia commissioned a report into the Physician Assistant and their potential role in the Australian health workforce. This report was completed in November 2011 and earlier this year was tabled to the Australian Health Ministers Advisory Council for consideration and it has now just been formally released. This comprehensive report conducted an extensive literature review of supporting documentation regarding Physician Assistants from overseas evidence and considered the impact of the two Australian Physician Assistant trials, which were conducted in Queensland and in South Australia. In addition the report also considered submissions from various key stakeholders such as personnel from the rule and remote health sector, Physician Assistant graduates and students from the Australian PA programs conducted by University of Queensland and other professional bodies representing nurses and doctors. The findings of this report are overwhelmingly supportive of the introduction of the Physician Assistant into the Australian health workforce. A number of concerns were raised by some respondents about introducing a new health professional, such as the competition of training placements for junior doctors and medical students, and potential competition with the existing nurse practitioner role. It is interesting to note that the report could not find any evidence that supported either of these two arguments. One thing the report alludes to is that the acceptance of the Physician Assistant role is based on the level of understanding. The greater the respondent understood the role of the Physician Assistant that more likely it was to be accepted. What does this report mean for Australian Physician Assistants?